Patient Navigation Specialist

Summary

Join Forge Health as a Patient Navigation Specialist and become a key member of our Revenue Cycle team. You will be responsible for verifying client insurance coverage, ensuring services are covered across our facilities in New York, New Jersey, Pennsylvania, New Hampshire, and Massachusetts. This remote position requires extensive phone communication with insurance companies to document benefits, obtain prior authorizations, and utilize insurance websites for processing and follow-up. You will collaborate with clinical staff and maintain strict client confidentiality. The ideal candidate possesses 3+ years of insurance verification and authorization experience, a Bachelor's degree, and strong analytical and organizational skills. Forge Health offers a competitive salary, comprehensive benefits, and opportunities for professional development.

Requirements

• 3+ years of Insurance Verification and Authorization experience required, with 2+ years experience in the healthcare sector preferred
• Bachelors degree required
• Extremely detail-oriented with excellent analytical, problem-solving, and organizational skills
• Ability to keep confidential medical records of patients
• Works well in groups as well as individually, with minimal supervision
• Flexible, adaptive, punctual, and highly reliable

Responsibilities

• Responsible for verifying client’s insurance coverage to ensure necessary services are covered
• Requires extensive amounts of time on the phone with insurance companies
• Document detailed benefits and covered amounts provided by the insurance policy
• Obtain prior-authorizations for services as required by the clients insurance policy
• Work with insurance companies to initiate, follow-up and complete prior authorization using telephone and insurance company websites
• Utilize insurance websites to accurately process authorizations, upload medical record documentation, and follow up on pending authorizations
• Work with clinical staff and management for assistance when clinical information is needed
• Ensures strict confidentiality of personal client information and data
• Drafts and edits documents/communications, as needed
• Assists clinical staff in providing excellent customer service to all clients
• Any other duties as required by supervisor

Benefits

• Competitive salary aligned with your experience
• Comprehensive paid time off package
• Annual time off to volunteer
• Parental leave
• Annual continuing education allocations
• Competitive medical, dental, and vision package
• Annual subscription to a leading meditation app
• An environment that fosters professional development including financing for advanced licensure and certifications
• Internal supervision opportunities
• Dedicated, motivated team and chance to be part of a highly ambitious medical startup
• Modern, elegant, and high-end work environment